health care

Anthem is back in the news. You might remember that just a short while ago Anthem refused to pay for Emergency Department care they deemed not to be an emergency. [1] Their latest attempt to rein in their costs is restricting access to anesthesiologists or nurse anesthetists for many cases of cataract surgery.

Cataract surgery involves cutting the lens of the eye, removing the deposits creating a cloudy vision and replacing the lens. It is a very common procedure, especially in the Medicare population. The eye can be anesthetized, so that the patient does not feel pain, with topical medications. But patients have to lie still. Some patients are physically not capable of lying flat, some patients are just too anxious about someone cutting their eye, and they need a bit of...

Often considered meaningless use or meaningful abuse by those who actually practice medicine, the so-called meaningful use reform legislation, included in Congress’ government funding bill just signed by President Donald Trump, with respect to electronic health records (EHRs) is a necessary step toward assuaging somewhat the real life onerous nature of EHR implementation. The bill hopes to ease the mandated increasingly stringent...

All I want for Christmas is for people just to tell it like it is in medical advertising in all its forms. Promise nothing more and nothing less than what they, their institution or product actually do or mean. Stop the selling. If it or you are the real deal, then allow that to speak for itself. Whatever isn’t won’t last anyway, so being authentic will serve everyone in the long run and expedite the process.

Think Theranos (see here). Or, the ability to keep your doctor with Obamacare. The hubris of company 23andMe which warranted FDA intervention and sanction. And on and...

Where is the best state to practice medicine? I would argue the latest study on the topic does little to answer the question given the metrics chosen. But, the project does provide a template and way to calculate your personal level of interest in the pre-selected benchmarks. The result is a starting point that guides your thought process more than it might firm up any decisive actions on the subject.

Given the parameters of cost of living, residency retention rate, tax climate, physician density, malpractice premiums (averages) and Medicare’s Geographic Cost Index (1),...

I get it. Actress Jessica Chastain hates guns. But, Ms. Chastain, please don’t use your platform to spread untruths about the medical profession to make a political point. When you have nearly 600,000 twitter followers, the damage is done even if you inevitably delete your tweet. Which you did.

Clearly, after the tragic events this week in Las Vegas, emotions are high and discussions around gun violence are going to happen. That's fine. However, making inaccurate statements about medical testing does not advance any gun control argument and serves to do potential harm.

After much online criticism today, Ms. Chastain deleted the following tweet without explanation - fellow actor James Woods had re-tweeted it:

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For most of us, the word “doctor” in the health care setting tends to conjure up a person who completed college, innumerable pre-med requirements, medical school, internship, residency and possibly specialty fellowship (sometimes more than one). It implies a long road that ranges more than a decade, inclusive of countless board examinations with continued recertification, annual mandatory continuing medical education credits and accounts for exposure to the most clinical hours of other staff personnel in breadth, depth and scope.

It is this description that we think of when the individual responsible for our care in the hospital or an emergency room or outpatient facility interacts with us. They are no better than any other caregiver albeit a nurse, respiratory therapist or you-...

Since I am a huge proponent of laughter often being good medicine, I didn’t have to look very far to find funny movie scenes that also delivered meaningful medical lessons.

Limiting the number of options became the challenge!

So, here are 5 examples from films where medical knowledge can be extracted from the humor (of note, be aware there is cursing in some of the linked clips and so may be NSFW) :

Space Cowboys (2000)

Clint Eastwood, Tommy Lee Jones, Donald Sutherland and James Garner play former NASA crew members finally getting their shot to go on a repair mission in space. To do so, they must meet the same physical standards, usually by much younger colleagues, to get the go ahead to undertake their dream...

When it comes to higher usage of low-value CT Scans, MRIs and x-ray imaging along with increased specialty referrals, ownership and location of primary care practices appear to matter. So says a new study published in JAMA Internal Medicine which further concludes the following:

“Ultimately, these results raise general concerns about the provision of low-value care at hospital-associated primary care practices. Because almost one-third of health spending is considered potentially wasteful, our findings have important implications for policymakers, health care practice leaders, and clinicians, who have an interest in providing the highest-quality care at the lowest per capita...

Obamacare was always about health coverage, not health care. Whatever destiny awaits its future iteration —albeit repeal, replace, repair, what have you, Trumpcoverage would be a better suited name than Trumpcare

If the highest quality of medical care persists in being of unequal consideration to access where continuity of care is permitted to fragment further and individual choice of physician be ever limited, then we all lose no matter the new enactments.   

Whatever your political affiliation, all we hear about from both sides of the aisle are the two aspects of Obamacare that we all desire to keep: not penalizing those with pre-existing conditions and covering young adults under their parents plans until age 26. Bravo to those who...

In a world where optics, buzzwords and marketing magic carry as much meaning if not more than — it seems— the actual validity of the core concept or technology, nothing baffles me more than how a Theranos was able to rise and fall so precipitously and garner a multi-billion dollar valuation. Or, raise such capital at all from the start.  

Fundamentally, the company’s promise of “groundbreaking finger-stick technology" was the reinvention or rebranding of an existing technology:  the microtainer (aka the pediatric bullet).  I will get to that shortly.

The power of marketing or a good story that can sell is likely what...